Exam 10: Management of Discomfort

Benzodiazepines (Valium, Ativan), when given in conjunction with opioid analgesia, appear to enhance pain relief and reduce nausea and vomiting. Because of the positive effects of this combination, benzodiazepines are frequently used during labor.

Which statement correctly describes the effects of various pain factors?

Nursing care measures are commonly offered to women in labor. Which nursing measure reflects application of the gate-control theory?

The role of the nurse with regard to informed consent is to:

An 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The woman states, "My contractions are so strong that I don't know what to do." The nurse should:

With regard to a pregnant woman's anxiety and pain experience, nurses should be aware that:

A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:

A first-time mother is concerned about the type of medications she will receive during labor. She is in a fair amount of pain and is nauseous. In addition, she appears to be very anxious. You explain that opioid analgesics often are used with sedatives because:

To help patients manage discomfort and pain during labor, nurses should be aware that:

With regard to nerve block analgesia and anesthesia, nurses should be aware that:

A woman in labor has just received an epidural block. The most important nursing intervention is to:

Opioids such as hydromorphone, fentanyl, and meperidine can cause excessive CNS depression in both the mother and newborn. Opioid antagonists such as naloxone (Narcan) can promptly reverse the CNS depressant effects, especially respiratory depression. The RN should use caution in administering naloxone to opioid dependent women in labor.

Maternity nurses often have to answer questions about the many, sometimes unusual, ways people have tried to make the birthing experience more comfortable. For instance, nurses should be aware that:

Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help patients. Nurses should know that _____ women may be stoic until late in labor, when they may become vocal and request pain relief.

A woman in labor is breathing into a mouthpiece just before the start of her regular contractions. As she inhales, a valve opens, and gas is released. She continues to inhale the gas slowly and deeply until the contraction starts to subside. When the inhalation stops, the valve closes. This procedure is:

In the current practice of childbirth preparation, emphasis is placed on:

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intravenous fluid for a preprocedural bolus. She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm³. Which factor would contraindicate an epidural for the woman?

Today the pregnant woman has a number of nonpharmacologic measures available to her to assist with pain relief in labor. One such measure involves the application of heat, cold, or pressure to specific areas of the body and is known as ________________.

After change-of-shift report, the nurse assumes care of a multiparous patient in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is: